Which instruction is important for the nurse to include in discharge teaching for a client who has to perform intermittent urinary self catheterization?

A urinary catheter tube drains urine from your bladder. You may need a catheter because you have urinary incontinence (leakage), urinary retention (not being able to urinate), prostate problems, or surgery that made it necessary.

Clean intermittent catheterization can be done using clean techniques.

Urine will drain through your catheter into the toilet or a special container. Your health care provider will show you how to use your catheter. After some practice, it will get easier.

Sometimes family members or other people you know such as a friend who is a nurse or medical assistant may be able to help you use your catheter.

Catheters and other supplies can be bought at medical supply stores. You will get a prescription for the right catheter for you. There are many different types and sizes. Other supplies may include towelettes and lubricant such as K-Y Jelly or Surgilube. Do not use Vaseline (petroleum jelly). Your provider can also submit a prescription to a mail order company to have the supplies and catheters delivered to your house.

Ask how often you should empty your bladder with your catheter. In most cases, it is every 4 to 6 hours, or 4 to 6 times a day.

Always empty your bladder first thing in the morning and just before you go to bed at night. You may need to empty your bladder more frequently if you have had more fluids to drink.

Avoid letting your bladder get too full. This increases your risk of infection, permanent kidney damage, or other complications.

Follow these steps to insert your catheter:

• Wash your hands well with soap and water.
• Collect your supplies, including your catheter (open and ready to be used), a towelette or other cleaning wipe, lubricant, and a container to collect the urine if you are not planning to sit on the toilet.
• You may use clean disposable gloves if you prefer not to use your bare hands. The gloves do not need to be sterile unless your provider says so.
• Move back the foreskin of your penis if you are uncircumcised.
• Wash the tip of your penis with Betadine (an antiseptic cleaner), a towelette, soap and water, or baby wipes the way your provider showed you.
• Apply the K-Y Jelly or another gel to the tip and top 2 inches (5 centimeters) of the catheter. (Some catheters come with gel already on them.) Another type is soaked in sterile water which makes them self-lubricated. These are called hydrophilic catheters.
• With one hand, hold your penis straight out.
• With your other hand, insert the catheter using firm, gentle pressure. DO NOT force it. Start over if it is not going in well. Try to relax and breathe deeply.

Once the catheter is in, urine will start to flow.

• After urine starts to flow, gently push in the catheter about 2 more inches (5 centimeters), or to the "Y" connector. (Younger boys will push in the catheter only about 1 inch or 2.5 centimeters more at this point.)
• Let the urine drain into the toilet or special container.
• When urine stops, slowly remove the catheter. Pinch the end closed to avoid getting wet.
• Wash the end of your penis with a clean cloth or baby wipe. Make sure the foreskin is back in place if you are uncircumcised.
• If you are using a container to collect urine, empty it into the toilet. Always close the toilet lid before flushing to prevent germs from spreading.
• Wash your hands with soap and water.

Some catheters are meant to be used only once. Many others can be re-used if cleaned appropriately. Most insurance companies will pay for you to use a sterile catheter for each use.

If you are reusing your catheter, you must clean it every day. Always make sure you are in a clean bathroom. Do not let the catheter touch any of the bathroom surfaces; not the toilet, wall, or floor.

Follow these steps:

• Wash your hands well.
• Rinse out the catheter with a solution of 1 part white vinegar and 4 parts water. Or, you can soak it in hydrogen peroxide for 30 minutes. You can also use warm water with soap. The catheter does not have to be sterile, just clean.
• Rinse it again with cold water.
• Hang the catheter over a towel to dry.
• When it is dry, store the catheter in a new plastic bag.

Throw away the catheter when it becomes dry and brittle.

When away from your house, carry a separate plastic bag for storing used catheters. If possible, rinse the catheters before placing them in the bag. When you return home, follow the above steps to clean them thoroughly.

Call your provider if:

• You are having trouble inserting or cleaning your catheter.
• You are leaking urine between catheterizations.
• You have a skin rash or sores.
• You notice a smell.
• You have penis pain.
• You have signs of infection, such as a burning sensation when you urinate, a fever, or chill.

Clean intermittent catheterization - male; CIC - male; Self-intermittent catheterization

Dauw CA, Wolf JS. Fundamentals of urinary tract drainage. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

Davis JE, Silverman MA. Urologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 55.

Updated by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Which instruction is important for the nurse to include in discharge teaching for a client who has to perform intermittent?

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